两种术式治疗老年肱骨近端三部分骨折的对比研究  

The comparative study of two kinds of operations to the elderly patients with Neer three-part of proximal humeral fractures

作　　者：郭震[1,2] 刘晓东[1,2] 姚勐炜[1,2] 吴旭[1,2] 涂意辉[1,2] 

机构地区：[1]同济大学附属杨浦医院骨科 [2]上海市杨浦区中心医院骨科,200090

出　　处：《中国矫形外科杂志》2013年第8期751-756,共6页Orthopedic Journal of China

基　　金：上海市科委自然科学基金项目(编号:11ZR1434100)

摘　　要：[目的]比较切开复位锁定加压钢板内固定与人工肱骨头置换治疗老年肱骨近端Neer 3部分骨折的疗效。[方法]99例老年肱骨近端Neer 3部分骨折患者,53例行切开复位锁定加压钢板内固定(A组),46例行人工肱骨头置换(B组),对手术时间、术中出血量、骨折愈合时间、并发症和肩关节功能等进行临床随访分析。[结果]平均手术时间和出血量A、B组差异无统计学意义(P>0.05);骨折愈合时间A组与B组比较差异有统计学意义(P<0.05);并发症发生率,A组低于B组,差异有统计学意义(P<0.05)。A组和B组优良率分别为88.68%和73.91%,差异有统计学意义(P<0.01)。[结论]在掌握良好的手术技巧下,应用切开复位锁定加压钢板内固定治疗老年Neer 3部分骨折,可以获得满意的结果。而人工肱骨头置换术仍存在较多尚未解决的问题,选择时需慎重。[ Objective] To discuss characters of locked compressive plates internal fixation and humeral head replacement for treating elderly patients with Neer three-part of the proximal humeral fractures. [ Method ] Among 99 cases of elderly patients with Neer three-part of the proximal humeral fracture,53 cases were treated with locked compressive plates （ group A） and 46 cases were treated with humeral head replacement （group B）. Operative time, volume of blood loss, fracture healing time, compli- cations,postoperative function were observed and compared. [ Result ] On average operation time and blood loss, there was no significant difference between them （ P 〉 0.05 ）. There was significant difference in the fracture healing time （ P 〈 0.05 ）. The rate of complications in group A was lower than in group B, there was significant difference between them （P 〈 0.05 ）. Excellent and good results rate was 88.68% in group A,73.91% in group B,there was significant difference between them（P 〈0.01 ）. [ Conclusion ] Under technical tips, locked compressive plates internal fixation has satisfactory results in elderly patients with Neer three-part fractures, the humeral head replacement surgery still has many unresolved problems and needs careful considera- tion.

关 键 词：老年人 肱骨近端骨折 肱骨头置换 锁定加压钢板内固定 

分 类 号：R687.3[医药卫生—骨科学]